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There are groups of people who work towards the betterment of society. We know them better by the name of NGO or any charity organisation. The members choose to be a part of such groups voluntarily. NGOs and charities are not government bodies. In fact, they bring forth various challenging issues and strive to eliminate them in a legal manner, thus fostering the overall betterment of society.
NGOs or charities can be registered under Section 25 or 8 of The Company’s Act, 1956, Trust Act, Society Registration Act, or Non-Profit Private Limited Company and can be treated as a small company. Thus, all corresponding rules apply. NGO members are nothing but employees of this company. And it is crucial for companies to provide charity health insurance to them. As you guessed, the core of this article is all about Group Health Charity insurance for NGO employees.
A Group Health Insurance Policy provides insurance benefits to a group of people that are related to each other in some form or another. Since an NGO is also treated as a small company, its employees must also be given NGO health insurance. Charities need to follow the rules mentioned in section 25 or 8 of the Companies Act, 1956 for proper registration and other rules that are stipulated for the category. They can be registered under the following categories: trust/society/non-profit when registered under Trust Act, Society Registration Act, or Non-Profit Private Limited Company. For example, they will have to fulfil the minimum member requirement to be registered. Once such criteria are fulfilled, charities can proceed towards purchasing medical insurance for their employees.
Following are the key features and benefits of buying group medical insurance for NGO employees.
Group Health Insurance is also flexible in nature. The cover of this plan is not limited to the employees but extends to their families as well. A Group Health Insurance Policy can cover spouse, children and parent/parents-in-law.
The NGO or the charity will bear the cost of opting for charity care insurance. The employee can get access to all health insurance benefits without spending much for buying the policy. Sometimes the NGO may give an option to buy paid additional coverage to extend the scope of the policy.
Some insurers make it compulsory to undergo medical screening before a health insurance policy is generated. The test results can affect the coverage and premium of the policy. However, this step is not necessary in terms of Group Health Insurance.
One of the major benefits of Group Health Insurance coverage is that the insured persons can enjoy a faster turnaround time. This can be helpful in the time of a medical emergency.
The waiting period increases the out-of-pocket expenses of the insured person. One cannot raise a claim for a fixed number of years after purchasing a health insurance policy. For example, one cannot file a maternity claim immediately after buying a health insurance policy as the minimum waiting period of 9 months is applicable on the same. No such waiting period is applicable on a Group Medical Insurance Policy.
The only difference between buying a normal health insurance plan and a group plan is that in the case of a group plan, the company buys policy for its employees. While in a basic health insurance plan, the applicant is a single person.
Ideally, the company will weigh options like the type of insurance plan, cost of the policy, and benefits. Choosing a good insurance company is the next step after understanding the requirement.
Approach a few insurance companies that fit your search criteria. It is also a good idea to review the social media handles of insurance companies. This will give you an overview of the services and reputation of the insurer. Select the health insurance plan and get the best deal available.
The insurance regulator (IRDAI) has laid some rules for buying a Group Health Insurance Policy. An organisation needs to have at least seven members to be registered as an NGO. The NGO can buy Group Health Insurance after the registration process is complete.
Inclusions are conditions or situations where a policyholder can raise a claim. They define the scope of a policy. The following coverages are offered under ACKO’s Group Health Insurance policy.
Daily hospital cash
Road ambulance expense
Maternity and newborn baby medical expenses
Compassionate visit and stay
Access to wellness benefits such as ordering medicines, teleconsulting doctors, booking lab tests, etc.
Loss of pay due to hospitalisation as per the terms of the policy
EMI protection depending upon the coverage
Pre- and post-natal check-ups
Repatriation of mortal remains
Any other situation as mentioned in the policy document
All health insurance policies have general exclusions, i.e., situations that are not claimable under the policy. You can find the detailed list of exclusions on your ACKO policy wordings. Here are a few for your reference.
End of employment
Pre-existing diseases unless disclosed
Unemployment from consuming intoxicants
Other exclusions explicitly mentioned in the health insurance policy
Health insurance creates a financial backup for a medical emergency. You can safeguard yourself against a medical issue to ensure timely treatment. The haze over buying health insurance has lifted, especially after the COVID-19 pandemic. It is not an additional benefit that a company offers but a necessity. Since a group policy covers family members as well, this policy can help the insured person create a strong health insurance portfolio.
A Group Mediclaim Policy offers much more than only health insurance coverage. For example, with ACKO a company will get the following benefits for buying a group policy for their employees.
Paperless claims experience
Easy access to primary care
Health benefits in one app
Wide network of hospital PAN India
Flexible premium structure
Self-serve enrolment, which reduces administration costs
Raising a claim with a digital insurer like ACKO is easy. ACKO’s claim process is simple and transparent. ACKO settles claims faster than a traditional health insurance company. You can raise a claim in the following two ways.
All you have to do is intimate ACKO about the hospitalisation and raise a cashless claim by uploading the necessary documents. Medical treatment will begin as soon as ACKO receives all the details from you and the network hospital. ACKO will pay your hospital bill if the treatment is within the scope of your policy. You will just have to pay the deductibles as per terms and conditions. This way, you spend much less on availing of medical treatment.
Here are the steps for raising a reimbursement claim at ACKO.
Step 1: Intimate ACKO about the medical treatment
Step 2: Clear the entire hospital bill.
Step 3: Raise a claim from ACKO’s app or website and upload the necessary information/bills to request reimbursement of the expenses.
Sharing the necessary information with ACKO in a timely manner will be helpful to expedite your claim.
NGO stands for Non-Governmental Organisations.
Yes, charity care and health insurance are two different concepts. A person providing charity care is not bound under a contract to pay for the medical expenses. It is a voluntary service while a health insurance company is bound by the insurance policy to cover the cost of a medical emergency.
The employee does not have to pay anything for buying charity care health insurance. The cost of the policy for an employer depends on the coverage and sum insured of the policy.
To buy health insurance for charity, the organisation must have at least seven members.
An NPO (non-profit organisation) is a type of NGO. These are autonomous organisations that work for the benefit of society.